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Monoclonal Gammopathy of Undetermined Significance

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1. Monoclonal gammopathy of undetermined significance

Monoclonal gammopathy of undetermined significance Monoclonal gammopathy of undetermined significance - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Monoclonal gammopathy of undetermined significance Last reviewed: February 2019 Last updated: January 2018 Summary Asymptomatic pre-malignant disorder associated with relatively low risk (on average 0.5%-1.0% per year) of progression to multiple myeloma or related (...) plasma cell proliferative malignancies. No aetiological risk factors have been defined. Male gender, older age, family history of monoclonal gammopathy of undetermined significance, black ancestry, and exposure to radiation or pesticide are associated with a higher prevalence. There is no indication for specific treatment. Clinical- and laboratory-based follow-up is recommended. Definition Monoclonal gammopathy of undetermined significance (MGUS) is an asymptomatic disorder associated

2018 BMJ Best Practice

2. Long-Term Follow-up of Monoclonal Gammopathy of Undetermined Significance. (PubMed)

Long-Term Follow-up of Monoclonal Gammopathy of Undetermined Significance. Monoclonal gammopathy of undetermined significance (MGUS) occurs in approximately 3% of persons 50 years of age or older.We studied 1384 patients who were residing in southeastern Minnesota and in whom MGUS was diagnosed at the Mayo Clinic in the period from 1960 through 1994; the median follow-up was 34.1 years (range, 0.0 to 43.6). The primary end point was progression to multiple myeloma or another plasma-cell (...) (ratio of kappa to lambda free light chains) and a high serum monoclonal protein (M protein) level (≥1.5 g per deciliter) - was associated with a risk of progression at 20 years of 55%, as compared with 41% among patients who had one adverse risk factor and 19% among patients who had neither risk factor. Among patients with non-IgM MGUS, the risk of progression at 20 years was 30% among those who had the two risk factors, 20% among those who had one risk factor, and 7% among those who had neither

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2018 NEJM

3. Bone disease in monoclonal gammopathy of undetermined significance: results from a screened population-based study (PubMed)

Bone disease in monoclonal gammopathy of undetermined significance: results from a screened population-based study Previous studies have shown that individuals with monoclonal gammopathy of undetermined significance (MGUS) have an increased risk of fractures, although the underlying mechanisms remain unknown. Our aim was to analyze bone mineral density (BMD), bone volume, and risk of fractures among individuals with MGUS. We performed a screening using the Age, Gene/Environment Susceptibility (...) (AGES)-Reykjavik Study cohort, consisting of 5764 elderly individuals, identifying 300 individuals with MGUS, and 275 with light-chain MGUS. Quantitative computerized tomography was performed in the lumbar spine and hip to evaluate BMD and bone geometry. Analysis of variance and the Tukey honest significance test were used to compare the groups. Hospital records were used to record fractures, with a mean follow-up of 6.9 years. Cox proportional hazard was used to compare fracture risk. No difference

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2017 Blood advances

4. Obesity and risk of monoclonal gammopathy of undetermined significance and progression to multiple myeloma: a population-based study (PubMed)

Obesity and risk of monoclonal gammopathy of undetermined significance and progression to multiple myeloma: a population-based study All multiple myeloma (MM) cases are preceded by the premalignant state monoclonal gammopathy of undetermined significance (MGUS). Results from previous studies show a positive association between obesity and MM; however, the association between obesity and MGUS is controversial. The aims were to determine (1) if obesity is associated with an increased risk of MGUS

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2017 Blood advances

5. Dual anti-neutrophil cytoplasmic antibody and anti-glomerular basement membrane antibody-positive crescent glomerulonephritis in a patient with monoclonal gammopathy of undetermined significance: A case report. (PubMed)

Dual anti-neutrophil cytoplasmic antibody and anti-glomerular basement membrane antibody-positive crescent glomerulonephritis in a patient with monoclonal gammopathy of undetermined significance: A case report. Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and anti-glomerular basement membrane (GBM) antibody disease are both rare autoimmune diseases. Monoclonal gammopathy of undetermined significance (MGUS) is one of the most common causes of plasma cell dyscrasias (...) immunofixation electrophoresis found monoclonal immunoglobulin (MIg) G κ-light chain in the serum. Renal biopsy displayed crescentic formation in glomerule by microscopy and staining for liner IgG (+), sparse C3 (+-) and light chain (κ and λ) (+-) by immunofluorescence. The bone marrow examination indicated basically normal myelogram and sporadic plasma cells positive for CD38, CD138 staining, and κ light-chain restriction.Crescentic glomerulonephritis and MGUS.The patient was treated with plasmapheresis

2019 Medicine

6. Monoclonal gammopathy of undetermined significance: A primary care guide. (PubMed)

Monoclonal gammopathy of undetermined significance: A primary care guide. Monoclonal gammopathy of undetermined significance (MGUS) is commonly diagnosed in outpatients being worked up for an array of clinical concerns. It carries a risk of progression to myeloma and other lymphoproliferative disorders that, albeit low (1% per year), warrants regular follow-up. Patients with MGUS can be risk-stratified on the basis of the amount and type of their monoclonal protein as well as whether they have

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2019 Cleveland Clinic Journal of Medicine

7. MALDI-TOF analysis of blood serum proteome can predict the presence of monoclonal gammopathy of undetermined significance. (PubMed)

MALDI-TOF analysis of blood serum proteome can predict the presence of monoclonal gammopathy of undetermined significance. Monoclonal gammopathy of undetermined significance (MGUS) is a plasma cell dyscrasia that can progress to malignant multiple myeloma (MM). Specific molecular biomarkers to classify the MGUS status and discriminate the initial asymptomatic phase of MM have not been identified. We examined the serum peptidome profile of MGUS patients and healthy volunteers using MALDI-TOF

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2018 PLoS ONE

8. Monoclonal gammopathy of undetermined significance (MGUS). (PubMed)

Monoclonal gammopathy of undetermined significance (MGUS). Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant plasma cell dyscrasia that consistently precedes multiple myeloma (MM) with a 1% risk of progression per year. Recent advances have improved understanding of the complex genetic and immunologic factors that drive and permit progression from aberrant plasma cell clone to MGUS and overt MM. Additional evidence supports a bidirectional interaction of MGUS cells

2019 Blood

9. Parental longevity and survival among patients with multiple myeloma and monoclonal gammopathy of undetermined significance: a population-based study. (PubMed)

Parental longevity and survival among patients with multiple myeloma and monoclonal gammopathy of undetermined significance: a population-based study. Parental longevity is associated with an increased life expectancy; results with regard to specific diseases are conflicting. There are limited data focusing on host characteristics and their effect on survival among multiple myeloma (MM) patients and individuals with monoclonal gammopathy of undetermined significance (MGUS). Therefore, our aim (...) ·87, 95% CI 0·78-0·96). Having one long lived parent significantly decreased the risk of death in both groups, but was not statistically significant when both parents exceeded 90 years of age. In conclusion, parental longevity decreases the risk of death for patients with MM and MGUS which may reflect the importance of the host's genetic and environmental factors in relation to survival.© 2019 British Society for Haematology and John Wiley & Sons Ltd.

2019 British journal of haematology

10. Paraproteinemic keratopathy associated with monoclonal gammopathy of undetermined significance (MGUS): clinical findings in twelve patients including recurrence after keratoplasty. (PubMed)

Paraproteinemic keratopathy associated with monoclonal gammopathy of undetermined significance (MGUS): clinical findings in twelve patients including recurrence after keratoplasty. To describe the ocular findings of 12 subjects with paraproteinemic keratopathy associated with monoclonal gammopathy of undetermined significance (MGUS).Ocular examination included corneal spectral domain optical coherence tomography. In three individuals with an initial diagnosis of a lattice or Thiel-Behnke

2019 Acta ophthalmologica

11. Pro-inflammatory State in Monoclonal Gammopathy of Undetermined Significance and in Multiple Myeloma Is Characterized by Low Sialylation of Pathogen-Specific and Other Monoclonal Immunoglobulins (PubMed)

Pro-inflammatory State in Monoclonal Gammopathy of Undetermined Significance and in Multiple Myeloma Is Characterized by Low Sialylation of Pathogen-Specific and Other Monoclonal Immunoglobulins Multiple myeloma (MM) and its pre-cancerous stage monoclonal gammopathy of undetermined significance (MGUS) allow to study immune responses and the chronology of inflammation in the context of blood malignancies. Both diseases are characterized by the production of a monoclonal immunoglobulin (mc Ig (...) of 40 inflammation-linked cytokines, using Luminex technology. While pc IgGs from MGUS and MM patients showed heterogeneity in sialylation level, mc IgGs from both MGUS and MM patients exhibited a very low level of sialylation. Furthermore, mc IgGs from MM patients were less sialylated than mc IgGs from MGUS patients (p < 0.01), and mc IgGs found to target an infectious pathogen showed a lower level of sialylation than mc IgGs of undetermined specificity (p = 0.048). Regarding inflammation, 14

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2017 Frontiers in immunology

12. Prostate cancer leading to monoclonal gammopathy of undetermined significance: A case report (PubMed)

Prostate cancer leading to monoclonal gammopathy of undetermined significance: A case report Prostate cancer is one of the most common cancer types, affecting millions of individuals worldwide. The present study reported two cases of metastatic prostate cancer presenting with newly diagnosed monoclonal gammopathy of undetermined significance (MGUS). To the best of our knowledge, prostate cancer leading to MGUS has not been documented previously. MGUS is generally thought to be benign and has

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2018 Molecular and clinical oncology

13. Meningitis, spondylodiscitis, pneumonia and septic shock with Streptococcus pneumoniae in a previously healthy woman with isolated IgG2-, IgG3-, IgA-deficiency and monoclonal gammopathy of undetermined significance (PubMed)

Meningitis, spondylodiscitis, pneumonia and septic shock with Streptococcus pneumoniae in a previously healthy woman with isolated IgG2-, IgG3-, IgA-deficiency and monoclonal gammopathy of undetermined significance A 66 years old Caucasian woman with pneumococcal meningitis was treated and discharged after an uncomplicated course. Five months later she was readmitted with fever and right side abdominal pain and diagnosed with pneumococcal spondylodiscitis. One year later she was treated (...) and a bone marrow biopsy diagnosed her to have monoclonal gammopathy of undetermined significance. To protect her against future life threatening pneumococcal infections she was started on treatment with intravenous immunoglobulin. The case report illustrates the importance of thorough evaluation of patients with unusual infectious disease entities or unusual frequency of infections in individual patients. To optimize prophylactic measures and active treatment options in the individual patient

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2018 Infectious disease reports

14. Enrichment of B cell receptor signaling and epidermal growth factor receptor pathways in monoclonal gammopathy of undetermined significance: a genome-wide genetic interaction study (PubMed)

Enrichment of B cell receptor signaling and epidermal growth factor receptor pathways in monoclonal gammopathy of undetermined significance: a genome-wide genetic interaction study Recent identification of 10 germline variants predisposing to monoclonal gammopathy of undetermined significance (MGUS) explicates genetic dependency of this asymptomatic precursor condition with multiple myeloma (MM). Yet much of genetic burden as well as functional links remain unexplained. We propose a workflow

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2018 Molecular Medicine

15. Sarcoidosis and Monoclonal Gammopathy of Undetermined Significance (MGUS): A True Association or Just a Coincidence? (PubMed)

Sarcoidosis and Monoclonal Gammopathy of Undetermined Significance (MGUS): A True Association or Just a Coincidence? Sarcoidosis is a systemic inflammatory disease characterized by the presence of noncaseating granulomas in different organs. Sarcoidosis associated with monoclonal gammopathy of undetermined significance (MGUS) is a rare finding with only 10 cases reported to date. We describe a 79-year-old male patient who presented with dry mouth for 4 months. Lip biopsy done prior to admission (...) monoclonal gammopathy with an M-spike of 1.47. Bone marrow biopsy was consistent with MGUS. The patient showed significant improvement with steroids and was discharged with close follow-up from nephrology and oncology. Salivary gland involvement in patients with sarcoidosis is a rare finding. Our case is a valuable addition to the small number of cases described in the literature supporting an association between plasma cell disorders and sarcoidosis. Larger prospective studies are needed to determine

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2018 Case reports in hematology

16. Risk of progression of monoclonal gammopathy of undetermined significance into lymphoplasmacytic malignancies: determining demographic differences in the USA (PubMed)

Risk of progression of monoclonal gammopathy of undetermined significance into lymphoplasmacytic malignancies: determining demographic differences in the USA 29269527 2019 03 06 2019 03 06 1592-8721 103 3 2018 03 Haematologica Haematologica Risk of progression of monoclonal gammopathy of undetermined significance into lymphoplasmacytic malignancies: determining demographic differences in the USA. e123-e125 10.3324/haematol.2017.179978 Go Ronald S RS Division of Hematology Mayo Clinic, Rochester (...) Care Delivery; Mayo Clinic, Rochester, MN, USA. Shah Nilay D ND Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery; Mayo Clinic, Rochester, MN, USA. eng Letter Research Support, Non-U.S. Gov't 2017 12 21 Italy Haematologica 0417435 0390-6078 IM Age Factors Cell Transformation, Neoplastic Demography Disease Progression Humans Monoclonal Gammopathy of Undetermined Significance pathology Neoplasms, Plasma Cell etiology Sex Factors United States 2017 12 23 6 0 2019 3 7 6 0

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2018 Haematologica

17. Increased activated regulatory T cell subsets and aging Treg-like cells in multiple myeloma and monoclonal gammopathy of undetermined significance: a case control study (PubMed)

Increased activated regulatory T cell subsets and aging Treg-like cells in multiple myeloma and monoclonal gammopathy of undetermined significance: a case control study Accumulating evidence have indicated that regulatory T cells (Tregs) play an essential role in T cell-mediated immune response and development of multiple myeloma (MM). CD4+FoxP3+ T cells are composed of three phenotypically and functionally distinct subpopulations: CD45RA+FoxP3lo resting Tregs (rTregs), CD45RA-FoxP3hi activated (...) Tregs (aTregs) and CD45RA-FoxP3lo non-suppressive T cells (non-Tregs). We aimed to clarify the frequency and function of these three subpopulations in newly diagnosed multiple myeloma and monoclonal gammopathy of undetermined significance (MGUS) patients. In addition, CD28-CD4+FoxP3+ Treg-like cell is a senescent regulatory T cell subset with partial suppressive function, which could be impaired during myelomagenesis.we examined 20 patients with MGUS, 26 patients with newly diagnosed MM and 18

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2018 Cancer cell international

18. Disrupted radial and tibial microarchitecture in patients with monoclonal gammopathy of undetermined significance. (PubMed)

Disrupted radial and tibial microarchitecture in patients with monoclonal gammopathy of undetermined significance. Patients with monoclonal gammopathy of undetermined significance (MGUS) had abnormalities in volumetric BMD (vBMD), microarchitecture, and stiffness at both the radius and tibia by high-resolution peripheral quantitative CT compared to matched controls. This is the first report demonstrating that patients with MGUS have microarchitectural deficits at multiple skeletal (...) sites.Fracture risk is elevated in patients with monoclonal gammopathy of undetermined significance (MGUS). However, the pathogenesis of bone disease in these patients is poorly understood. Prior work using high-resolution peripheral CT (HRpQCT) demonstrated abnormal microarchitecture at the radius, with predominantly cortical abnormalities. We hypothesized that patients with MGUS have abnormal microarchitecture at both radius and tibia compared to controls, reflecting global skeletal effects

2018 Osteoporosis International

19. Mixed cryoglobulinemic membranoproliferative glomerulonephritis due to monoclonal gammopathy of undetermined significance: A case report. (PubMed)

Mixed cryoglobulinemic membranoproliferative glomerulonephritis due to monoclonal gammopathy of undetermined significance: A case report. Membranoproliferative glomerulonephritis (MPGN) can be induced by autoimmune diseases, chronic infection, chronic hepatitis, and paraproteins (including cryoglobulinemia). In addition, the mixed cryoglobulinemic MPGN is reported to be highly correlated with hepatitis C virus (HCV) infection.We reported a rare case of a 61-year-old woman without a history (...) of viral hepatitis infection; she presented with bilateral leg edema and proteinuria. Renal pathology revealed MPGN with multiple positive immunofluorescent staining. The consequent serum survey revealed positive cryoglobulin and monoclonal gammopathy of kappa type of immunoglobulin M. However, bone marrow study showed no obvious plasma cell proliferation, indicating that multiple myeloma was less likely.This patient's cryoglobulinemic MPGN could be related to monoclonal gammopathy of undetermined

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2018 Medicine

20. Case Report: Monoclonal Gammopathy of Undetermined Significance is Associated with <i>Loa loa</i> Infection. (PubMed)

Case Report: Monoclonal Gammopathy of Undetermined Significance is Associated with Loa loa Infection. A 63-year-old woman who migrated from Nigeria to the United States was found to have an elevated total serum protein, anemia, and eosinophilia. Serum protein electrophoresis (SPEP) and serum protein immunofixation electrophoresis (SPIFE) demonstrated monoclonal immunoglobulin G (IgG) κ restricted bands (IgG 3,820 mg/dL; κ/λ ratio 4.47), indicative of monoclonal gammopathy of unknown (...) . Treatment resulted in a resolution of the microfilaremia and eosinophilia, a negative RDT for malaria, and marked reduction in the monoclonal gammopathy. This is the first reported human case of MGUS associated with loiasis and its resolution after antiparasitic treatment.

2018 American Journal of Tropical Medicine & Hygiene

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